Purpose: :
To report that multiple usage of triamcinolone acetonide(TA) could be an aid to epiretinal membrane (ERM) and internallimiting membrane (ILM) peeling during ERM surgery. Thus, weevaluated surgical outcomes of ERM surgery with this method.

Methods: :
Fifteen eyes of 15 consecutive patients with ERM, aged55 to 80 years, underwent vitrectomy between Janualy 2004 andDecember 2004. TA was injected after removing the posteriorhyaloid. After TA particles settled onto retinal surface, theERM was stripped with forceps. When the ILM still looked shrinking,TA was injected again to distinguish ILM from ERM and/or ILM–denudedarea. The shrinking ILM was stripped with forceps. Best–correctedvisual acuity measurement, fundus examination and optical coherencetomography were performed before and after the surgery to determinethe anatomical and functional outcomes.

Results: :
Relatively large TA particles were trapped in ERMs.It made the visualization of ERM better and the stripping easier.On the other hand, the ILM was not stained with TA and the particlesjust settled on the ILM, so they could be blown away by theflow. TA had a character additionally that the fine white powderseamed to dyeing the ILM–peeled area in cases. After thesecond or third injection of TA, the ILM–peeled area couldbe distinguished as a whitish locus from the remaining ILM onwhich TA particles were less stuck. It facilitated the ILM peelingif necessary in these series. Best–corrected visual acuityimproved by two or more lines in 10 eyes and stabilized in 5of 15 eyes at 12 months after surgery. The mean visual acuitysignificantly improved from 0.44 preoperatively to 0.73 at 12month postoperatively. No adverse effects of corticosteroidexcept temporary ocular hypertention have been seen in any eyes.

Conclusions: :
TA was useful to visualize and distinguish ERMand/or ILM from the area denuded of them. Although further studiesare needed, multiple usage of TA could be an aid to ERM andILM peeling during macular surgery.